05:11 am - Thursday 20 September 2018

Non-surgical circumcision in Malawi

By Amalawi - Wed Apr 02, 10:41 am

Malawi: The Malawi Government and its partners such as the Medecins Sans Frontiers (MSF) will pilot a non-surgical circumcision procedure to assess the safety and acceptability of the method in the country.

A Senior Medical Doctor for MSF in Nsanje, Joseph Pulvirenti, said that studies suggest that the transmission of HIV among men engaging in heterosexual sex is 60 per cent less in circumcised men.

The new proposed procedure is relatively simple, this can be performed by clinical officers and nurses . It involves placement of a ring device around the foreskin of the manhood and then removal of the device and cutting away the dead foreskin on day seven.

Mr Joseph Pulvirenti explained that the new procedure could address two major concerns reported by men which are fear of pain and lost time from work associated with surgical circumcision.

“Getting this non-surgical circumcision will allow men to get back to work earlier than the surgical one,” he added.

He revealed that if the device is accepted and the study goes as expected, this may largely replace surgical circumcision in adult men because of the ease of doing the procedure and the lack of side effects.

Meanwhile, Medecins Sans Frontiers has embarked on awareness campaign aimed at informing more men about the non-surgical circumcision.

non-surgical circumsion

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  1. In Malawi today, it is the CIRCUMCISED who have markedly higher HIV incidence.  

    So cutting more men will….

    Most of the US men who have died of AIDS were circumcised at birth.  

  2. Abstinence and being faithful are indeed key but study has shown that most African men are not faithful to their partners. I commend what Joseph and the team are doing, if African men were faithful HIV rates in Africa and indeed Malawi would as low as they are in Europe and the rest of the world.

  3. While I certainly agree with Mr. Lyndon that abstinence, being faithful and use of the condom are excellent ways to decrease the spread of HIV, there is ample evidence in the medical literature that supports the claim that male circumcision decreases the risk of HIV disease also. The following articles may prove enlightening (Bailey et al. Lancet 369:643-656 found a decrease risk of men getting HIV who were circumcised in Kisumu, Kenya; Gray et al in Lancet 369:657-666 found the same in a study in Rakai, Uganda, as did Auvert et al writing in PLOS Med volume 2(11)e298. These studies were so convincing that the WHO and Joint UN Program stated in their 2007 guidelines that male circumcision is promoted as part of the total HIV Prevention Package. Additional studies afterwards (Bailey et al Bulletin World Health Group 2008:86:667-9 and Auvert et al in an abstract presentation to the World AIDS Conference in Rome continued to show data that male circumcision is protective for HIV negative men. In fact the estimation of the protected effect is about 67%. There is even a study which suggests that the transmission of HPV (the virus that causes genital warts) is also decreased (Waiver et al Lancet 2011:377:209-218).

    So in short, I agree that abstinence will certainly prevent the sexual transmission of HIV, that being faithful to your spouse will also decrease your risk (provided that your spouse is HIV negative) and that condoms also decrease the risk of HIV disease. However, studies have shown that male circumcision also decreases your risk especially if you ignore your ABCs.

    1. Tell it to the people who were told that circumcision would lessen their chances of HIV infection, and died of AIDS anyway, in the US. The figure approaches one million.

  4. Dear Mark,

    I’m afraid you are not well informed. The organization that you quote, DHS, says that male circumcision is a useful tool against HIV (cf their page here: http://dhsprogram.com/topics/male-circumcision.cfm). It also quotes the World Health organization that explains in this page (http://www.who.int/hiv/topics/malecircumcision/en/) that male circumcision, albeit not a foolproof method against HIV transmission, decreases risk of transmission by 60.

  5. There is little difference between having a foreskin surgically removed, and having it rot off from gangrene with a prepex device. Neither is a great way to protect against HIV.
    Circumcision only pretends to protect. In the US, we have buried nearly a million mostly circumcised men who died of AIDS. Condoms protect.

  6. Malawian men are *more* likely to have HIV if they’ve been circumcised:

    7.9% of intact Malawian men have HIV
    10.3% of circumcised Malawian men have HIV

    (figures from MeasureDHS)

    There are least nine other African countries where circumcised men are *more* likely to be HIV+ if they’ve been circumcised, and yet they’re promoting male circumcision to prevent HIV. Why? ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems likely to cost African lives rather than save them.

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